Key result
Reducing depression symptoms during pulmonary rehabilitation is linked to greater quality of life improvements.
Why the study?
Little is known about how depression symptoms and exercise self-efficacy affect improvements in health-related quality of life and exercise capacity following pulmonary rehabilitation.
Does baseline depression status and change in depression symptoms impact improvements in HRQoL and exercise capacity following pulmonary rehabilitation in veterans with COPD?
Observational (n=112)
Does baseline depression status and change in depression symptoms impact improvements in HRQoL and exercise capacity following pulmonary rehabilitation in veterans with COPD?
In veterans with COPD undergoing pulmonary rehabilitation, baseline depression does not preclude significant improvements in quality of life and exercise capacity, though reductions in depression correlate with greater quality of life gains.
Baseline depression should not exclude COPD patients from pulmonary rehabilitation; leaves open whether symptom reduction causally drives HRQoL gains.
Pulmonary rehabilitation (PR) improves health-related quality of life (HRQoL) and exercise capacity. Little is known about the impact of depression symptoms and exercise self-efficacy on improvements in these key PR outcomes. This study examined the impact of baseline depression status and change in depression symptoms (Beck Depression Inventory-II [BDI-II] score) over the course of PR on change in HRQoL assessed by the Chronic Respiratory Disease Questionnaire-Self Reported (CRQ-SR) and exercise capacity as measured by the 6-Minute Walk Test (6MWT). We also examined whether baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in these key PR outcomes. We studied 112 US veterans (aged 70.38 ± 8.49 years) with chronic obstructive pulmonary disease (COPD) who completed PR consisting of twice-weekly 2-hour classes for 18 sessions. Depressed (BDI-II >13) and nondepressed (BDI-II ≤13) patients at baseline demonstrated comparable and significant improvement in CRQ-SR total score, subscales, and 6MWT. Greater reduction in depression over the course of treatment was significantly associated with greater improvement in CRQ-SR total score and the following subscales: fatigue, mastery, and emotional function. Change in depression did not predict change in 6MWT distance. Baseline exercise self-efficacy moderated the association between baseline depression symptoms and change in CRQ-SR fatigue. Specifically, when baseline exercise self-efficacy was <30.4, greater baseline depression was associated with less improvement in CRQ-SR fatigue. When baseline self-efficacy was >152.0, greater baseline depression was associated with greater improvement in CRQ-SR fatigue. PR programs should address mood and confidence to exercise given their impact on key PR outcomes.
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Bamonti et al. (2021) conducted an observational in Chronic obstructive pulmonary disease (COPD) (n=112). Pulmonary rehabilitation vs. Nondepressed patients (BDI-II ≤13) was evaluated on Change in health-related quality of life (CRQ-SR) and exercise capacity (6MWT). Reduction in depression symptoms during pulmonary rehabilitation was significantly associated with greater improvement in health-related quality of life, while baseline depression did not limit gains.
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